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<html>
<head>
	<meta charset="utf-8">
	<meta http-equiv="X-UA-Compatible" content="IE=edge">
	<meta name="description" content="">
	<meta name="Keywords" content="">
	<title>我的需求清单_国药网</title>
	<link rel="stylesheet" href="/static/www/dist/style/base.css?version=20171116">
	<link rel="stylesheet" href="/static/www/dist/style/requireConfirm.css">
	<link rel="stylesheet" href="/static/www/dist/style/flex.css">
	<script type="text/javascript" src="/static/www/paramsForStatic"></script>
</head>
<body>
	<div class="settlement">
		<div class="w1200 clear requireW">
		<div class="successhtml">
			<form id="userInfoData"  method="post" enctype="multipart/form-data" target="sure_iframe" >
				<div style="display:none;">
	               <input type="text" name="addressId" class="userAddressId" id="addressId" value=""/>
	               <input type="text" name="userName" id="userName" value="" />
				</div>
				<div class="requireBox">
					<div class="consigneeBox clear">
						<p class="consigneeBt clear">
							<span>收货人信息</span>
							<span class="add_adress js_add_address">新增收货地址</span>
						</p>
						<div class="rq_adress_box">
								<div class="adr_list rq_adr_list"></div>
						</div>
						<div class="moreAdress js_adr_more">更多地址</div>
					</div>
					<div class="userConfrim">
						    <p class="clear">
							   <span>用户信息确认</span>
							   <span></span>
						    </p>
							<div class="userConfrim-item">
								<div class="item itemTell">
									<span class="label">联系人手机号：</span>
									<input type="text" class="item-tell" name="contactsMobile" placeholder="只允许输入11位手机号码" id="contactsMobile"/>
									<input class="item-checkbox" type="checkbox" name="itemChecked" id="itemChecked"/>
									<i>同收货人手机号</i><span class="checkTell">请输入正确的手机号码</span>
								</div>
								<div class="item clear">
									<span class="label">上传照片：</span>
									<div class="requireImg" >
										<div class="requireImgBox" id="re_imgBox">
											<div class="requireImgOne positonImg">
												<img src="static/www/image/requireConfirm/require-add.png" class="rq_imgBtn" onclick="showFile(this)"/>
												<img src="" class="msg" />
												<input type="file" name="imgPath1" class="photo" id="imgPath1" style="display:none;" multiple="multiple" onchange="setImagePreview(this);" accept=".png,.jpeg,.jpg,.bmp">
											    <span class="rq_deleteImg flex-wrap midCenter"><img src="static/www/image/member/delete.png" ></span>
											</div>
											<p class="checkImgSize"></p>
										</div>
										<div class="requireImgBox">
											<div class="requireImgTwo positonImg">
												<img src="static/www/image/requireConfirm/require-add.png" class="rq_imgBtn" onclick="showFile(this)"/>
												<img src="" class="msg"/>
												<input type="file" name="imgPath2" class="photo" id="imgPath2" style="display:none;" multiple="multiple" onchange="setImagePreview(this);" accept=".png,.jpeg,.jpg,.bmp">
												<span class="rq_deleteImg"><img src="static/www/image/member/delete.png" ></span>
											</div>
											<p class="checkImgSize"></p>
										</div>
										<p>如有处方单，请上传，谢谢；支持格式png/jpg,小于2M</p>

									</div>
								</div>
								<div class="item">
									<span class="label">备注：</span>
									<input type="text" class="remark" placeholder="限50个字" id="remark" name="remark" maxlength="50"/>
								</div>
							</div>

					</div>
					<h1 class="requireBt clear">
						<span>商品信息确认</span>
						<span class="right"><a href="/requireList">返回需求清单</a></span>
					</h1>
					<!--*********************商品订单********************-->
					<table class="table">
						<thead>
							<tr>
								<td>商品信息</td>
								<td>单价（元）</td>
								<td>数量</td>
								<td>小计（元）</td>
							</tr>
						</thead>
						<tbody id="goodsBody">
						</tbody>
					</table>
				</div>
				<div class="require_price"></div>
				<span class="cut_off"></span>
				<div class="rq_submit"><input type="submit" value="提交需求" id="require_submit_c" class="confirm-submit"></div>
				<div class="require_surePrice">
					<p class="rq_surePriceCon">应付金额：<em>￥</em></p>
				</div>
			</form>
		    <iframe id="sure_iframe" name="sure_iframe" style="display:none;"></iframe>
		</div>
		</div>
	</div>

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	<script src="/static/www/dist/script/address.js" type="text/javascript"></script>
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